Prof Keith Roberts @UHB_HPB Twitter profile

Last Seen Profiles

@fromdusktildawn

@hayami_sewo

@FieldViewFrance

@futurewaswritte

@stwmaniax

@terasawachan

@FantasyPL_FPL

@cukienaknikmati

@dvorkinwalter

@Niels_Albert

@minami_inrevo

@Norah92977

@StickinFrance

@leedawm

@tinotino677

@bokeplokalmalam

@ITuttero

@BoltonChampions

@highwayzer0

@minoyama_bito

@MorganSloss

@HhH95277

@OTAKU_BOOMBOX

@ITuttero

@sekam_dualima

@parkkwangon

@Alamo

@Pluezirslq_B

@SwarajKadam77

@Connor173339

@fagundes_nuno

@bil_gad

@El_Tacleador

@4ColorCrack

@YakliHay

@miaouuv2

Prof Keith Roberts

@UHB_HPB

9 months

Med twitter, don't blast me, just asking... Would trainees want a partial reversal of limits of hours they can work (train) so that the team based approach to training can return? More hours = more money, means less need for non medical workforce delivering care too

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Prof Keith Roberts

@UHB_HPB

2 years

I and many others are indebted to Prof Paolo Muiesan for his mentoring, guidance and support. Absolutely tireless in his pursuit of perfection and patient care. A remarkable man and colleague. Rest in peace Paolo. My deepest sympathies to your family and loved ones. In memoriam:

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Prof Keith Roberts

@UHB_HPB

10 months

Honored and excited to say that @ThePancSocGBI is coming to Birmingham in 2025. But Dublin first with President @OonaghGriffinRD in 2024!

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Prof Keith Roberts

@UHB_HPB

3 years

Really pleased to see the first output from our RICOCHET national pancreatic cancer audit. Variation and underuse of PERT despite NICE guidance. Many patients are wasting away and suffering needlessly. Thank you to all Collaborators, trainees and steering group

Ricochet Study

@RicochetStudy

3 years

Thanks to the brilliant work of all our collaborators, we will soon be publishing ‘Pancreatic enzyme replacement therapy in patients with pancreatic cancer’ - #PERT is a key component of #pancreaticcancer care but we are not doing enough to provide it to our patients yet!

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Prof Keith Roberts

@UHB_HPB

3 years

More data supporting direct to surgery for jaundiced pdac. Time for UK RCT of NAT in resectable cancer? jaundiced pt - stent+NAT vs direct surgery + adjuvant chemo

Nicola de'Liguori Ca

@deLiguoriCarino

3 years

Excellent presentation by @harryvmspiers on #Manchester #HPB Unit experience on fast track resection for #periampullary malignancies. #PancreaticCancer @CnsHpb @HpbUnit @PancreaticCanUK @aileen_aherne @DerekAOReilly @TeamGIMS_MRI @UHB_HPB @OfficialPCA @hpb_stockport @GM_Cancer

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Prof Keith Roberts

@UHB_HPB

3 years

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Prof Keith Roberts

@UHB_HPB

10 months

@DrSfpb presenting her research on novel diagnostic test in PEI. Very exciting data after lots of hard work. Absolute pleasure to have supervised her PhD. Thank you

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Prof Keith Roberts

@UHB_HPB

5 years

Excellent data. What is unresectable pancreatic cancer? That definition changes in our unit, like many others, almost monthly. Let's collaborate, standardise definitions, learn and support each other to offer as many patients as possible safe surgery and a chance for cure

Benjamin Loveday MBChB PhD FRACS

@BenPTLoveday

5 years

Harvest of left renal vein to use as interposition graft for portal vein reconstruction associated w mild acute kidney injury in first few post op days, resolves by day 7. No impact on long term renal outcomes. @hpbjournal @TorHPBFlwshp #VisualAbstract

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Prof Keith Roberts

@UHB_HPB

4 years

We've had all summer to prepare for this. Facilitate surgeons, anaesthetists and theatre nurses to operate at clean sites and protect those workers from being pulled in to treat covid. Cancer surgery needs to continue. Weekends, nights, anytime

Robert Sutcliffe

@liveRPancSurg

4 years

BBC UK coronavirus update. Simon Stevens NHS chief exec: “Cancer treatments are at or above their normal levels” - this is fake news, please show me the evidence. @BorisJohnson @BBCNews

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Prof Keith Roberts

@UHB_HPB

3 years

Going to be a great meeting and Belfast a wonderful city to visit. First conference in person for me since covid. Face to face registration closes TOMORROW! @roux_group @markataylor16 @liveRPancSurg

AUGIS

@Augishealth

3 years

UGI Congress 2021 - See our short film on plans for this October's meeting:

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Prof Keith Roberts

@UHB_HPB

4 years

Hilar cholangio. Calling all trainees. Please look at arterial anatomy as well as biliary anatomy. One uncommon anatomical variant of the coeliac/sma (not relevant to the planned resection) and a few HA variants that are @roux_group @liveRPancSurg @robjones1979 @HpbMo

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Prof Keith Roberts

@UHB_HPB

3 years

For hpb trainers and trainees, interesting read. Trainee registry for pancreatic anastomosis coming very soon from @paranoia_group with help from @roux_group Not a UK trainee? Get in touch and make sure your training group will be represented @ProfDemartines @SurgeryHPB

Stefan Stättner

@SStattner

3 years

AddThis | Home @paranoia_group @UHB_HPB @rupaly_pande 👍

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Prof Keith Roberts

@UHB_HPB

2 years

Paolo Muiesan (1961-2022)

In memoriam: Paolo Muiesan (1961-2022) • ESOT

It is with great sadness that ESOT announces the passing of Professor Paolo Muiesan. Fate has been unfair to Paolo, keeping him far from his beloved Andrea and Matteo and far from his country for...

esot.org

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Prof Keith Roberts

@UHB_HPB

5 years

Neoadjuvant therapy for pancreatic cancer in a nutshell - two patients in two days. First received one cycle of FOLFIRINOX over 4 months since diagnosis due to delays in pathway, complications of biliary drainage and now has ascites and ca19-9 over 6000. The other completed FOLFI

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Prof Keith Roberts

@UHB_HPB

1 year

The paper work from one of my studies was reviewed by R+D. Pls see the recommended actions. Don't know if to 😂or😭. Anyway, better to learn from other people's mistakes, don't say I didn't warn you if you're caught using too many 'polypockets'

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Prof Keith Roberts

@UHB_HPB

5 years

First data from @RicochetStudy and @rwilkin_1 - wide variation (and undertreatment) of PEI and PERT in the UK. Thank you to all collaborating teams and @PancreaticCanUK for supporting this national prospective audit of Pancreatic Cancer. More over the coming months

Neil Bibby

@neilbibby87

5 years

Really interesting data shared at #PCUKStudyDay we need to do better for our non surgical patients ⁦ @HpbUnit ⁩ ⁦ @nigps ⁩

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Prof Keith Roberts

@UHB_HPB

2 years

@siobhanmckay @drsoniagill @Murali_HPBSurg @Austin_Health @ANZHPBAinc @roux_group @HelenMohan1 @mrnigeldsouza @broadhitch_char Surgical trainees. Ditch EWTD. Embrace the team approach to on call and excellent, consistent, mentorship. Enjoy training, feel and be part of the system, not fodder to the on call rota

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Prof Keith Roberts

@UHB_HPB

5 years

RINOX NAT and resected despite >180 degree SMA involvement. Both fit <60 years. We're working to improve pathways, reduce times to treatment and risks of complications but much still to do. @siobhanmckay @Drsampathak @PancreaticCanUK @precisionpanc @ImprovePanc @BritSocGastro

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Prof Keith Roberts

@UHB_HPB

11 months

Would you like to see standardised radiology reporting of pancreatic cancer in the UK? Read the PACT-UK consensus statement at code 87536158 if you agree, endorse the statement

Enter the Code to Join & Vote on a Presentation - Mentimeter

Enter the code from the Mentimeter presentation to join in and start voting. Make your voice heard!

www.menti.com

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Prof Keith Roberts

@UHB_HPB

3 years

Full impact of covid across all patients becoming clear. The NHS was at capacity pre covid. More resource, ring fenced, for cancer and transplant service, is needed to recover and protect our patients from the pressures of emergency care

Dmitri Nepogodiev

@dnepo

3 years

LOCKDOWNS Myth: Lockdowns are to 'protect' the NHS Realities: Good- Lockdowns reduce COVID-19 deaths. Bad- Cancer surgeries get delayed; 1 in 6 patients may miss their surgery altogether. Solution: Implement COVID-19 mitigations early to avoid lockdown

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Prof Keith Roberts

@UHB_HPB

4 years

Very important study and will provide data in the near future. Please support and join this work

CONTACT Pancreas

@ContactPancreas

4 years

LAUNCHED TODAY! Join us for the most comprehensive evaluation of COVID upon pancreatic cancer care in the UK. Register you hospital at and more info at @PancreaticCanUK @RCSnews @GBIHPBAnews @PancSocGBI @UHB_HPB @siobhanmckay

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Prof Keith Roberts

@UHB_HPB

4 years

@liveRPancSurg There seems to be widespread under reporting of how severely affected cancer surgery pathways are. I don't understand why the NHS does not acknowledge this. Perhaps the covid deniers and mask dodgers would respond more sympathetically and appropriately if they understood this.

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Prof Keith Roberts

@UHB_HPB

4 years

@HPBResearchUK @MarcBesselink @markataylor16 @hpbsurgeon1 @ProfW_edinsurg @liveRPancSurg @HPB_Surgeon @MinterWiscSurg Interested to know more about your own outcomes? PARANOIA platform will be freely available for users to see their own risk adjusted outcomes and CUSUM plots. Don't be PARANOID! improving outcomes through better understanding of POPF

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Prof Keith Roberts

@UHB_HPB

5 years

Just one of the problems with a delay to treatment of pancreatic cancer. RICOCHET will help us understand the pathway so we can improve. "The third option of stent-surgery-chemo should be abandoned" I couldn't agree more

Robert Sutcliffe

@liveRPancSurg

5 years

@georgiapapacle @Adam_Frampton1 @UHB_HPB @HealthierLSC @PancreaticCanUK As data supporting neoadj chemo emerges the question is which resectable patients should have (1) stent-chemo-surgery versus (2) surgery-chemo. The third option of stent-surgery-chemo should be abandoned. 2/2

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Prof Keith Roberts

@UHB_HPB

5 years

More great work from the Dutch. The usual suspects. What can be modified? Centre volume.... In the UK we have centralised surgical services but not oncology. Time to review and rethink how we deliver this? Many providers will treat <10 patients per Yr... In Birmingham we will....

Marc Besselink

@MarcBesselink

5 years

Nationwide study @hpbjournal : 33% of 1306 pts did not receive adj chemo after resection of #PancreaticCancer . Next to higher age, worse perform. status and annual volume <40 Whipples, this is mostly related to surgical complications

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Prof Keith Roberts

@UHB_HPB

3 years

The primary role of PARANOIA platform is to give surgeons their own risk adjusted outcomes. Nicely shown here, surgeon 1 is the outlier, not surgeon 2. Real data from our team. Also nicely shows a learning curve for the new consultant. @MarcBesselink @Shrikhande_SV @chiaro_del

PARANOIA Study Group

@paranoia_group

3 years

Last week we asked what you would do if you were the Head of a Pancreatic Surgery unit (Surgeon 1) and shown Fig 1. 132 votes were cast and 79% wanted more information.. As requested, here is a second graph (Fig 2) which shows the risk adjusted CUSUM plot for both surgeons (1/3)

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Prof Keith Roberts

@UHB_HPB

3 years

@jshabbir @goldstone_tony @DHSCgovuk @nhs_pensions @TheBMA @Vish_Sharm @Krishanx Completely agree. Big tax bill heading my way this year because of exceeding annual allowance. What do I do if/when the Trust come to me asking to do extra sessions to catch up with surgery to tackle COVID backlog? My hands are tied. @sajidjavid

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Prof Keith Roberts

@UHB_HPB

3 years

UK pancreas surgeons and trainees - register for this one day face to face event at the newly refurbished RCS A great chance to catch up with friends and experts in UK pancreatic cancer surgery and discuss planned and current research. Monday May 23rd

RCS pancreas research symposium

One day face to face event to discuss UK pancreatic cancer research

www.eventbrite.co.uk

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Prof Keith Roberts

@UHB_HPB

4 years

@liveRPancSurg @BorisJohnson @BBCNews We've had all summer to prepare for this. Facilitate surgeons, anaesthetists and theatre nurses to operate at clean sites and protect those workers from being pulled in to treat covid. Cancer surgery needs to continue. Weekends, nights, anytime

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Prof Keith Roberts

@UHB_HPB

3 years

@SurgJournal @DrDariusMirza @BiSTC1 @unibirmingham @hpb_so @AHPBA @EAHPBA @SoMeTransplant @me4_so @DrLakhtakia @TheNotoriousHPB @DrEmamaullee @motazqadan @shimulshah73 @KM_Pawlak @JulioIglGar @helpatologist @CaitlinWHicks @SWexner BDI happens. Phone a friendly HPB surgeon. Interesting we didn't see immediate repair was best (heterogeneous data so MA not possible) but on table repair best outcome IMO and taught to us by @DrDariusMirza + pt has single GA and wakes with problem sorted, not problem starting

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Prof Keith Roberts

@UHB_HPB

1 year

What anticoagulation do you do after portomesenteric resection at pancreatoduodenectomy? Does it affect outcomes? Please join this project

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Prof Keith Roberts

@UHB_HPB

5 years

@santiazagra @HPBResearchUK @MarcBesselink @markataylor16 @hpbsurgeon1 @ProfW_edinsurg @sanjay_p99 @liveRPancSurg @HPB_Surgeon @MinterWiscSurg @CHL_Luxembourg Risk adjusted assessment of individual surgeon's pancreatic fistula ou... We can critically evaluate surgical performance using published scores and providing CUSUM plots. PARANOIA project coming soon

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Prof Keith Roberts

@UHB_HPB

4 years

@liveRPancSurg @AnnSurgOncol @KadriExhevit @McMastersKelly @SocSurgOnc No. Hundreds of patients operated with jaundice in Birmingham. Low or high (<or >300micromol/l) no diff in complications/mortality. We have prospective data collection by dedicated data manager. Abstract only but manuscript on the way:

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Prof Keith Roberts

@UHB_HPB

1 year

PEI session at EAHPBA lunchtime today. Treating PEI as effective as surgery in pancreatic cancer??

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Prof Keith Roberts

@UHB_HPB

5 years

Great way to improve pathways, patient experience and outcomes

HPB.CNS@mft

@CnsHpb

5 years

#MFT are proud to be Launching the Rapid Access clinic from Monday 8th July for all patients under the care of @TraffordCCG and @ManchesterHCC @OfficialPCA @PancreaticCanUK @MFT_Surgery #FasterDiagnosis

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Prof Keith Roberts

@UHB_HPB

5 years

@deLiguoriCarino Great idea. Let's do this collaboratively with invitation to mdt colleagues from all UK pancreatic centres to develop consensus with support from RCS and AUGIS. Invitation to follow. @markataylor16 @Abuhilal9Abu @nigeljamieson @Augishealth @roux_group @Declanfj @DerekAOReilly

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Prof Keith Roberts

@UHB_HPB

4 years

Cha from sma, splenic from aorta. Lha gives off gda. RHA also abn. Gives off small branch to r post segment and a s4 branch. The rha then gives branch to r ant pedicle but continues as major r post branch. Usually rha divides extra hepatic to r post then r ant pedicle

Prof Keith Roberts

@UHB_HPB

4 years

Hilar cholangio. Calling all trainees. Please look at arterial anatomy as well as biliary anatomy. One uncommon anatomical variant of the coeliac/sma (not relevant to the planned resection) and a few HA variants that are @roux_group @liveRPancSurg @robjones1979 @HpbMo

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Prof Keith Roberts

@UHB_HPB

3 years

Dear UK surgical trainees+med students. You are offered a surg training number+have the option of working current jr doc contract with shift working+compensatory rest or a 24hr on call with rest only on the day after but a firm based structure of training. Which would you pick1/3

Shifts+compensatory rest

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Firm based+24hr on call

477

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Prof Keith Roberts

@UHB_HPB

1 year

😲Wow, many questions. Something to do with pathways? Usual idiosyncrasies of RCT vs real world will need interrogation. But, restores faith in the role of surgery.

Robert Sutcliffe

@liveRPancSurg

1 year

@Bham_HPB_LTx @UHB_HPB @NChatzizacha @DaveCBartlett

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Prof Keith Roberts

@UHB_HPB

4 years

Exciting progress from our colleagues at UHCW! Looking forward to seeing what you and Gab do next

Jawad Ahmad

@Jawad004

4 years

Unpacking my new toy 🤖👘

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Prof Keith Roberts

@UHB_HPB

4 years

@liveRPancSurg @EwenGriffiths @drkeithsiau @CalmnKeep @RodriguezParra_ @pathaksudh Meta-analysis shows reduced rates of popf with external but not internal stent. PARANOIA team working on this, and other, systematic reviews and meta analyses ahead of launch of PARANOIA. watch this space @paranoia_group

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Prof Keith Roberts

@UHB_HPB

4 years

Lots of ♥️for the pringle. Much less blood loss, shorter anaesthetic, clear views of the resection plane, ischaemic preconditioning if you believe in that. Big thanks to Pete Lodge and Giles Toogood for enlightening me when I was their trainee (and CUSA technique)

Chris Nahm

@chris_nahm

4 years

@HalletJulie @DrEmamaullee @hpbsurgeon1 @timpawlik @liveRPancSurg @ProfW_edinsurg @jhatjhmi1 @ewenharrison @FlavioRochaMD @sapisochin @TheNotoriousHPB @HPB_Surgeon @hpbsurgeonNJ @sanjay_HPB @daikisoma_iu @TekniklyPerfect @HpbMar @HPB_Txp_Surg @HpbMo @UHB_HPB @hpbSurgery_NZ

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Prof Keith Roberts

@UHB_HPB

2 years

Nice dissection. To answer your question with a question, the SMA margin is the most frequently involved margin - should divestment of the SMA to expose its right side be routine in resectable pdac?

Tamara Gall

@gall_tamara

2 years

HPB Twitter - Should this be the standard resection for PDAC? I have worked with those who don’t do extensive resection and those where this is routine. Thoughts?

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Prof Keith Roberts

@UHB_HPB

2 years

@jameshallesmith @hpbjournal @sanjay_HPB @Drsampathak @DrSfpb @rupaly_pande James, great work as always. Though EOF feasible, do pts get sufficient nutrition? What is impact on rates of adjuvant therapy if they don't? Are there alternatives or adjuncts to EOF? join James and the team for the discussion at the RCS May 23+24

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Prof Keith Roberts

@UHB_HPB

5 years

..... present the findings of our 'fast recovery' quality improvement study funded by #PCUK in the near future. It aims to improve the recovery of patients after surgery, particularly addressing frailty and malnutrition/PEI

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Prof Keith Roberts

@UHB_HPB

2 years

@MichelePaduano @bbcmtd Well done Mo, you are an inspiration. Good luck with your return to work

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Prof Keith Roberts

@UHB_HPB

3 years

@ejsotweets @jameshallesmith @rupaly_pande @surgeon_young @nigeljamieson @ThePancSocGBI @precisionpanc @ESSOnews @deLiguoriCarino @EAHPBA @IHPBA @hpb_so This is good data. Supports surveillance. What do you do? Do we need level 1 evidence? If you say yes, how to conduct that study? Equipoise, pt pref, costs, problems of surveillance trials. The Dutch have a novel trial solution.... If you say no, do we standardise UK practice?

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Prof Keith Roberts

@UHB_HPB

2 years

Great chance to get involved in research, make a big difference for our patients. Find a topic for a study, higher degree or just come and listen

The Roux Group

@roux_group

2 years

Interested in Pancreatic Nutrition research? Here is a full day with some of the top researchers in the field. May 24th at @RCSnews . Registrations are free here: @rupaly_pande @UHB_HPB

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Prof Keith Roberts

@UHB_HPB

1 year

For all hospital CNS that look after pancreatic cancer patients, a national nurse led quality improvement research project. Join us, May 23rd at the University of Birmingham

COALESCE

@COALESCE_panc

1 year

Join us for the COALESCE launch 23rd May at Hornton Grange, Birmingham. Tickets are limited so register soon! @UHB_HPB @ProfAnnieT @rupaly_pande @pinkney_t @bicops

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Prof Keith Roberts

@UHB_HPB

1 year

@rajibaji1983 @BigBaldDr @SyedAAhmad5 @AmJSurgery @UCincySurg @SocSurgOnc @SSATNews @juliomayol @TomVargheseJr @SAGES_Updates @TsengJennifer @KSSSurgery @Declanfj @Jawad004 Good Q. PARANOIA has a tool for trainees to measure their progress. This can also be used to show trainers and training committees what training is offered. Early days, encourage all trainees to sign up and present their experience @Augishealth @roux_group @rupaly_pande for info

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Prof Keith Roberts

@UHB_HPB

5 years

Great set of papers/body of work - thank you!

Ville Sallinen

@villesallinen

5 years

At #NordicHPB meeting Nov 2019 Helsinki @ksoreide presented the best HPB papers of 2019. I thought you’d like to hear them and Kjetil was kind enough to share his slides. #tweetorial ensues: #SoMe4HPB #SoMe4Surgery

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Prof Keith Roberts

@UHB_HPB

3 years

@SurgeryHPB @MarcBesselink @nigeljamieson @ASCO @DPCG_official @Caspervaneijck @EAHPBA @AHPBA @IHPBA @EurPancClub @PancreasVerona @aalisheen @deLiguoriCarino @DerekAOReilly @PancreaticCanUK Gem++ and rt vs gem + was the main diff, not the timing in relation to surgery. 'Surprise', the pts that received more therapy did better

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Prof Keith Roberts

@UHB_HPB

5 years

What is needed here are more trials; until one shows a benefit.....

Tim Underwood

@TimTheSurgeon

5 years

Well blow me down, who’d have thought it?

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Prof Keith Roberts

@UHB_HPB

4 years

@liveRPancSurg @roux_group @robjones1979 @HpbMo You have to get up early to get past Sutcliffe. The splenic v is also lost. Some calcification in the pancy head? Chronic panc but There is suspicion of mass at the pancreatic neck...

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Prof Keith Roberts

@UHB_HPB

4 years

Opportunity to train with a great team!

Declan

@Declanfj

4 years

Looking for our next senior fellow, from August 2021. Applications close 10/3/2021. DM if questions @RyanDBaron @Kooliebear @mraraty @UHB_HPB @Augishealth @markataylor16 @AUGISt_UK @GBIHPBAnews @JohnAGMoir @deLiguoriCarino @vincent_yip

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Prof Keith Roberts

@UHB_HPB

4 years

Time, +pan-cancer, waits for noone. Risk vs benefit:depends on pretest probability of cancer. If surgery the next step, do you need this, or do you want it so you never make a mistake? 20-25% of pts progress in 6 wks, that's an easy mistake to make. When did you last see igg4...

Nadeem Tehami

@helpatologist

4 years

Should all pancreatic solid lesions be biopsied before any surgery❓ I don’t think so. If the history / labs / radiology is supportive of a ♋️ then they should go straight for surgery @IHPBA @UHB_HPB @teoh_anthony @Abuhilal9Abu @abubakarhaf @KM_Pawlak #eustwitter

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Prof Keith Roberts

@UHB_HPB

3 years

@SharanWad @MDcarpediem @motazqadan @JCanAssnGastro @alan_barkun @Zogopoulos_G @yeni_mtl @cutitoutPODCAS1 @jmosko29 @SunilAminMD @drdalbir @tsewingman @KM_Pawlak @marshllj @RoiAnteby Thirty years of Whipple pathology error rate at UHB to be published soon @jameshallesmith . Rate continues to reduce and is around 2% in suspected cancer. Given the risk with over investigation on cancer progression, I think, on balance, systems are working well. #

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Prof Keith Roberts

@UHB_HPB

2 years

@DerbyPBunit @MISIRG1 @Cirbosque Nice case from a great team

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Prof Keith Roberts

@UHB_HPB

3 years

@caitlinahester @AnnalsofSurgery Outcome dependent on many variables. Importantly healthcare services+populations health+life expectancy⬆️over time. black+white yes/no recommendations are thus fixed at historic + out of date period. ⬆️age,complexity+better outcome-30yrs PD @UHB TBC @jameshallesmith @DrDariusMirza

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Prof Keith Roberts

@UHB_HPB

3 years

Well done Siobhan, an excellent job

Siobhan Mckay

@siobhanmckay

3 years

And thank you for all the support @Augishealth @GBIHPBAnews @bariatricBOMSS @markataylor16 @maynard_nick @martinswadley @EwenGriffiths @SurgeryHPB @UHB_HPB @TimTheSurgeon @Surgerygirl8

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Prof Keith Roberts

@UHB_HPB

4 years

@SharanWad That's what I'm talking about. Adc=Adenocarcinoma, and yes it's bad. The rest, you've lost me.

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Prof Keith Roberts

@UHB_HPB

3 years

@ksoreide Good Q! In our hands, Upper limit around 600. If renal function OK. If renal function not OK, external Bil drain and operate within the week. French paper suggests more complications >300 but we have not seen that

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Prof Keith Roberts

@UHB_HPB

2 years

@richlaing @HalletJulie @me4_so @hpb_so @IHPBA @AHPBA @CHPBAsurg Thanks, PERT I believe is the single easiest factor to improve outcome+pt experience. Improves qol, nutrition+extends survival. Registries to quickly assimilate data on strategies in non metastatic pdac. Upskilling surgical teams to treat BR+LA pdac: equal opportunities for pts

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Prof Keith Roberts

@UHB_HPB

5 years

@Declanfj @surgeon_young @Aiims1742 @hopkinskimmel @jhatjhmi1 @DrRABurkhart @RyanDBaron @mraraty @shabbarankine Excellent pathways in Liverpool. Time to rethink how we deliver adjuvant chemotherapy in the UK?

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Prof Keith Roberts

@UHB_HPB

4 years

@surg1979 @Shrikhande_SV @gimalleo @Gio_Marchegiani @MarcBesselink @HPB_Txp_Surg @TheNotoriousHPB @mkatzmd @chiaro_del @SyedAAhmad5 @CFerroneMD @HalletJulie @HpbMar @hpb_so @HpbKarolinska @HPB_Surgeon @MadameSurgeon @hpb No evidence that re-resection of benefit though intraop I'd take another margin. If positive difficult decion of total panc vs call it a DAY (probably TP) As others have said the key is FOLFIRINOX so ensure best chance: Pert, physio, engage oncology

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Prof Keith Roberts

@UHB_HPB

2 years

@liveRPancSurg @SyedAAhmad5 @gbonneysurg @RSnyder_MD @GregWilson152 @isteaus @TheNotoriousHPB @DenboJw @mkatzmd @SurgJournal @AnnSurgOncol @juliomayol @IHPBA @Shrikhande_SV @MarcBesselink @Bham_HPB_LTx @DrDariusMirza @paranoia_group Agree about learning curve. Too early for @paranoia_group to show results, but that is the goal. Sign up, contribute to the data and let's look at this question, and get your own risk adjusted outcomes /CUSUM plots at the same time. Good question and discussion👍

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Prof Keith Roberts

@UHB_HPB

3 years

@dnepo @davidnnaumann @richlaing 1/7 rota. Week nights,Week off,Week days,Week off,3 weeks 'normal' days (take your AL here) . Or, one weekend on call, six off, cover the 5 weekdays at some point over the seven weeks. All other days in the week with the team. I can train the latter, v hard to train the former.

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Prof Keith Roberts

@UHB_HPB

3 years

@yannoulias @_HSMCentre Thanks Basil. Good work. It's presently very challenging just delivering cancer care, let alone optimising a service. CONTACT will help show this. NHS needs to rethink how close to full capacity it can run and how complex services are delivered. @siobhanmckay @ContactPancreas

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Prof Keith Roberts

@UHB_HPB

3 years

@helpatologist @abubakarhaf @IHPBA @TeamSurgery247 @T4UGIS @gvraoaig @zaedHamady @Abuhilal9Abu @liveRPancSurg @altaf_awan12 @Liver_Surgeon Great images. No difference, but surgeon needs to recognise the plumbing preop to prevent a mishap.... . There would be implications for BR and LA resection though, dependent on tumour location and contact

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Prof Keith Roberts

@UHB_HPB

3 years

@SharanWad @roux_group @siobhanmckay @liveRPancSurg Look at the size of the abdo wall muscles and muscles around the hip. 🐂🍰=beefcake=steroid use=bleeding adenoma (+risk of malignant transformation). Good scan and case

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Prof Keith Roberts

@UHB_HPB

9 months

@DrRJWebb OK, but who is going to do those tasks?

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Prof Keith Roberts

@UHB_HPB

2 years

@JudeDockray @theresecoffey @TheBMA I had a bronze award last year recognising activity over+above my paid role. My THEORETICAL pension growth is>£160,000! Dreading the tax bill. No wonder NHS has a motivation and staffing issue. We want to work but it makes no financial sense to do so

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Prof Keith Roberts

@UHB_HPB

4 years

@drkeithsiau @DeMadaria @MISIRG1 @KM_Pawlak @OribaDan @SWexner @DrJonnys @DrMohdZein @Boborodada @drdalbir @NEndoscopy What we really need is a novel diagnostic test to overcome many failings of present diagnostic tests and that can assess response to pert. @DrSfpb is on it...

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Prof Keith Roberts

@UHB_HPB

2 years

@harryvmspiers @liveRPancSurg @AliZakaria_MD @IHPBA Good discussion! Upfront surgery without biliary drainage vs Nat. Upfront surgery after biliary drainage should be avoided where possible. The RCT that's needed is to compare those first two groups in resectable pdac

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Prof Keith Roberts

@UHB_HPB

2 years

@MarcBesselink @BasGrootKoerkam @CFerroneMD @chiaro_del @nigeljamieson @ewenharrison @IHPBA @EAHPBA @AHPBA Great to catch up after so long. #EAHPBA23 Lyon will be 👍👍👍

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Prof Keith Roberts

@UHB_HPB

2 years

@Tanno_Lulu Patience or Propofol without too much pressure via the CD. Thank you Prof Paolo Muiesan

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Prof Keith Roberts

@UHB_HPB

3 years

@DoctorAkashD Dude, where were you the last five years? 😂 Sorry, legacy of the 'new deal' argued for on your behalf by trainees to reduce hours in training. Own goal is my brief summary of that one

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Prof Keith Roberts

@UHB_HPB

2 years

@richlaing @UHNM_NHS Well done Rich, great team and great addition

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Prof Keith Roberts

@UHB_HPB

4 years

@markataylor16 @PancSocGBI @MylanNews @PancreaticCanUK This debate is really important and should be quite thought provoking. Calling all those that treat pancreas cancer throughout the UK

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Prof Keith Roberts

@UHB_HPB

5 years

Great opportunity! Good luck Rob

Robert Jones 🇬🇧

@robjones1979

5 years

@TimTheSurgeon @UHB_HPB @markataylor16 @glasgow_derek @Toffino12

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Prof Keith Roberts

@UHB_HPB

4 years

@SGaibrie Sorry, give me 24 hrs anytime over 3,4 or 7 consecutive nights. My bodyclock hated them and I had much worse training. We've lost the team structure in surgery with shifts in the UK. There could be a happy medium between 80+ hrs and current UK working regs.

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Prof Keith Roberts

@UHB_HPB

3 years

@MarcBesselink @DPCG_official @EurPancClub @PancreasVerona @EAHPBA @IHPBA @YouppiePancreas @JCO_ASCO @BasGrootKoerkam @DeltaplanA Or multiagent therapy is better than single agent gemcitabine? Is the difference the timing of chemo or the type(s) or both?

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Prof Keith Roberts

@UHB_HPB

4 years

Done

Operation COVID #OpCOVID

@OpCovid

4 years

** #OpCOVID phase 3 official launch** Rapid (1-phase) global Delphi consensus on #OperatingRoom practice in #COVID19 . All disciplines and nations welcome. Please participate and share. #SoMe4Surgery #OpCOVID #Delphi @researchwelsh ➡��

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Prof Keith Roberts

@UHB_HPB

3 years

@cutitoutPODCAS1 @IHPBA @SAGES_Updates @me4_so @hpb_so Can't see the right posterior duct filling. I'm guessing disconnected duct.....tho that doesn't explain why bile duct fills via sinogram. Hole at both ends? May settle, may need the 🔪

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Prof Keith Roberts

@UHB_HPB

3 years

@helpatologist @hepbilsurgeon @abubakarhaf @IHPBA @SAGEJournals @Shrikhande_SV @SyedAAhmad5 @mj_pucci @hpbsurgeon1 @kashifoncosurg @TheNotoriousHPB @liveRPancSurg @drmwjames @NEndoscopy @DrLakhtakia @amolbapaye @gvraoaig Upfront surgery-avoid Bil drain/or Nat - sems. Stent and surgery to be avoided where possible. Eus decompression may be viable alternative, reduced risk of pancitis but? Cholangitis. Would benefit from a trial.

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Prof Keith Roberts

@UHB_HPB

1 year

@dnepo @HPBResearchUK @liveRPancSurg @ewenharrison @siobhanmckay @richlaing @Tom_Drake1 PEI and PERT is a very good topic, what to do with acute mesenteric thrombosis, registry for necrotising pancreatitis-management and outcomes

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Prof Keith Roberts

@UHB_HPB

3 years

@rupaly_pande @deLiguoriCarino @ksoreide That was quick! No flies on @rupaly_pande

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Prof Keith Roberts

@UHB_HPB

4 years

Plastic...

Florian Primavesi

@FPrimavesi

4 years

Quick question for the liver-surgeons: Who is routinely using metalstents for preop biliary drainage of hilar CCCs in their department? Looking for potential collaborators. @EAHPBA @ESSOnews @SStattner @deLiguoriCarino @schnitzb @UHB_HPB @liveRPancSurg @HPBDublin @hpbjournal

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Prof Keith Roberts

@UHB_HPB

2 years

Terrible, I hope she is OK. Attempted theft of my motorbike middle of the day this week @uhbtrust Thanks to security for stopping the theft BUT they were threatened with hammers and an angle grinder. Only a matter of time before someone badly hurt. @WestMidsPCC

Neil Rajoriya

@NeilRajJ1

2 years

..really sad my wife @uhbtrust mugged on-site last night, in the QEHB hospital @WHSmith finishing her nursing shift with phone stolen. What sort of society do we live ?! Sad people do this to any other human beings let alone targeting staff at work in hospitals.

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Prof Keith Roberts

@UHB_HPB

3 years

@markataylor16 @ViatrisInc @EurPancClub @ThePancSocGBI @Augishealth Thanks Mark. Great data from RICOCHET. Though not all patients with pancreatic cancer receiving PERT, 55% now vs 21% five years ago, and higher than other int'l series. Evidence NICE guidance and the msg about PERT getting through, yet still room to improve @PancreaticCanUK

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Prof Keith Roberts

@UHB_HPB

3 years

@chris_nahm @JasSamra8 @nigeljamieson @HalletJulie @TheNotoriousHPB @HPB_Txp_Surg @HpbMar @Shrikhande_SV @surgeon_young @davidjcav I usually use inf approach first, later ant or r ant and then join the two. gemini forceps and diathermy. Used to CB routinely, but now selectively - had a 180degree twist after SMV resection and CB... Triangle for LA. I use a J Incision, best of midline and subcostal for access

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Prof Keith Roberts

@UHB_HPB

3 years

@ProfKarolSikora BS. It's a civil responsibility to get vaccinated. Don't like it? Don't share the benefits of interacting fully in society. current ITU cases are the unvaccinated and young. My colleagues and I still can't offer our full cancer and transplant service due to ongoing nhs strain

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Prof Keith Roberts

@UHB_HPB

3 years

@dnepo @TheLancet @RCSnews @RCSEd @RCSI_Irl @RCoANews @rcpsglasgow @RCObsGyn @aneelbhangu @ewenharrison @ASiTofficial @NatalieBlencowe Thank you. Very depressing. Do you have a calculator for cancer +/- transplant activity? Could our politicians show this to the unvaccinated and ask if their personal choice to not take the vaccine is fair and equitable? Staggering just how selfish we can be

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Prof Keith Roberts

@UHB_HPB

4 years

@helpatologist @shahzadriyaz Interesting case. Right age and location for a SPEN. bloody aspirate in keeping but amylase is not. I'd be tempted to do a big biopsy...

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Prof Keith Roberts

@UHB_HPB

4 years

@SpringerSurgery @LAOS1860 Early surgery for pancreatic cancer is more challenging than ever at this time. Every delay to surgery reduces the likelihood of resection

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Prof Keith Roberts

@UHB_HPB

4 years

@drkeithsiau @DeMadaria @MISIRG1 @KM_Pawlak @OribaDan @SWexner @DrJonnys @DrMohdZein @Boborodada @drdalbir @NEndoscopy Pdac pts need ppi as duct obn common=<hco3 Start with 50k OK but you assume pts will be rv'd... Pts lucky to get pert let alone further rv so start 75k=pragmatic. 50k and fibrosing colitis in pharma websites are legacy of trials and data (or lack of) in this field. Nice rv keith

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Prof Keith Roberts

@UHB_HPB

1 year

@rajibaji1983 @RoyalSurrey @GuildfordHpb @KSSSurgery @whawkinssurgery @Augishealth @IHPBA Top job, great team!

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Prof Keith Roberts

@UHB_HPB

2 years

@liveRPancSurg @ProfW_edinsurg @Surgerygirl8 Been called worse!

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Prof Keith Roberts

@UHB_HPB

4 years

@mevparekh Cardiothoracic trainee publication requirement calculator= Nmax of publications needed by any other specialty +1. Who'd have guessed? Who are the t and o training committee kidding?? Two publications. 'Why I use a big hammer' and 'why I don't like using the little hammer' 🤣🤣

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Prof Keith Roberts

@UHB_HPB

4 years

Literally, top job!

Nicola de'Liguori Ca

@deLiguoriCarino

4 years

@UHB_HPB @liveRPancSurg @HpbMo @hpbnorth @HPBDublin @Ms_C_Jones @HpbMar @Declanfj @robjones1979 @MStott88 @petecoe1 @iestyn_shapey @dvdellen @surgeon_young @jeremyjfrench @IHPBA @EAHPBA @surg1979 @YouppiePancreas @DrDariusMirza @ProfW_edinsurg @shahidfarid

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